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Centre International de Développement et de Recherche (CIDR)

About the Project
Project Name: 
Health Product diversification and improvement of institutional efficiency of the schemes
Type of Facility Project: 
Innovation Grant
Pays d’opération: 
Guinea
Région: 
Africa
Project Thematic Focus: 
Insitutional models and business processes
Product: 
Health
Type of Risk Carrier: 
mutual or community-based
Type of Distribution Channel: 
Mutuals, community-based organizations
Project Description: 

The project seeks to improve the existing MHO sustainability by diversifying the products they offer. The first phase will implement a mandatory coverage for maternity at the village level as well as a mandatory accident and illnesses coverage for children at school. In a second phase, the MHO will expand the scope of their activities and target formal workers.
A second objective is to improve the quality and efficiency of health care by implementing performance based on contracts with health care providers.
Eventually, the project will strive to improve the MHO' efficiency by strengthening their information system and marketing strategy.

Consortium Members: 

Established in 1999 as part of a health insurance programme by CIDR, l'Union des Mutuelles de Santé de Guinée Forestière (UMSGF), is a regional network that governs and provides technical services to 35 MHO in Guinea. UMSGF has been providing microinsurance products for 8 years with CIDR support. Currently covering about 22 000 people in the 3 districts of Lola, Nzérékoré and Yomou, UMSGF offers a voluntary family health package that covers primary health care and hospitalizations.

Beneficiaries: 

CIDR expects to reach 21,000 women through the maternity coverage and 50,000 school children with the accident and illness coverage.

Lessons from the Project
Learning Agenda: 
  • What is the value of basic health insurance for the rural poor and especially of maternity coverage?
  • To what extent can the poor benefit from health insurance in the context of inadequate health services infrastructure?
  • What are key strategies for sustainability of MHO? Is a product diversification strategy sufficient? What are other ways to improve efficiencies and stabilize MHO financial performance?
  • What are the specific mechanisms to reduce adverse selection, moral hazard and frauds?
  • What is an efficient marketing strategy to promote these kinds of products?
  • How an innovative group product, as village based maternity coverage, could boost the current individual products?
Emerging Lessons: 
  • Covering deliveries only in case of complications does not appear to be sufficiently attractive to ensure high demand, nor give it significant impact in terms of public health. However, coverage of all antenatal visits does not make it possible to design a product at an acceptable price for families. External sources of financing need to be set up.
  • In the case of a mandatory product at the village level, it is important to think about effective population counting methods that yield quality information at an affordable price.
  • It is essential to motivate premium and data collectors in order to achieve effective management.
  • It is important to take family size into account when determining premiums for collective products.
  • Limiting coverage to class times may have negative impacts in terms of health behaviours.
  • The school product is easy to set up, especially in schools located near a health unit.
  • Subscribing to the school product has been facilitated by the involvement of the Ministry of Education’s representative.
  • The school product shows great potential for being cost-effective.
  • For the time being, the safe motherhood product is not cost-effective and seems to need external financial support to break even.
  • The diversification of products renders the task of mutual managers more complex and makes procedures more cumbersome, in particular in terms of information flow and the collection of premiums.
  • The size of villages and the credibility of elected officials are determinant factors in gaining the membership of villages.
  • Villages in which community projects are being carried out seem more disposed to subscribing to the safe motherhood product.
  • The success of the safe motherhood product requires a high level of commitment on the part of Union staff, which had been limited in this second campaign (due in particular to the preparation for the scheduled departure of CIDR’s project manager).
  • Feedback from agents showed this product’s attractiveness among teachers.
  • Quality of care seems to be a determining factor in the attractiveness of health insurance products.
  • In a situation of frequent supply shortages, the creation of a mutual stock of drugs makes it possible to improve the quality of care.
  • Payment of bonuses to health workers is effective only when the bonus amount for each worker is significant.
  • The coverage of ANVs and the training of birth attendants radically reduced the frequency of complicated deliveries.
  • Coverage provided by the safe motherhood product suggests a reduction in maternal mortality.
  • With time, a mutual structure heavily dependent on volunteers and the leadership of elected officials shows its limits.
  • It is important to pass responsibility on to the villages as soon as they join, in order to avoid the development of a “project” culture in which work is carried out by the Union.
  • The strategy of product diversification will not of itself ensure the viability of the mutual insurance Union.
Learning Journey: 
Learn more about the lessons that CIDR is learning in this project.
About the Organization
Relationship with the Facility: 
Innovation grantee
Country of Head Office: 
France
Region : 
Europe
Type of institution : 
Non government organization
Participation in Microinsurance: 
Consulting support
Organizational Overview: 

Centre International de Développement et de Recherche (CIDR - International Centre for Development and Research) is a non-governmental organization (NGO) created in 1961. It aims to strengthen the capacity of local institutions and microentrepreneurs in the informal economy of a dozen African countries, by promoting microfinance, service enterprises, territorial development In several of these countries, CIDR is also involved in supporting mutual health organizations (MHO).

More about the Organization
Websites: 
CIDR